Provider Demographics
NPI:1134209521
Name:MEDINA- FLORES, NOEMI (LCSW)
Entity type:Individual
Prefix:MRS
First Name:NOEMI
Middle Name:
Last Name:MEDINA- FLORES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:NOEMI
Other - Middle Name:CASTILLO
Other - Last Name:MEDINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2390 CRENSHAW BLVD # 265
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-3300
Mailing Address - Country:US
Mailing Address - Phone:951-692-5141
Mailing Address - Fax:951-692-5141
Practice Address - Street 1:2390 CRENSHAW BLVD # 265
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-3300
Practice Address - Country:US
Practice Address - Phone:951-692-5141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA282551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical